23D2183051 CLIA NUMBER - GRASS LAKE SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 23D2183051
  • Facility Name: GRASS LAKE SURGERY CENTER, LLC
  • Facility Address: 3800 CENTENNIAL BLVD
    GRASS LAKE, MI
    ZIP 49240
  • Facility Phone: 517 701-3100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: LORI HOFFMAN
  • NPI Number: 1790306991
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2183051
LAB Type Ambulatory Surgery Center
Facility Name GRASS LAKE SURGERY CENTER, LLC
Street 3800 CENTENNIAL BLVD
City GRASS LAKE
State MI
ZIP 49240
Phone 517 701-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Ambulatory Surgery Center
Lab Director LORI HOFFMAN

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This page was last updated on: 9/29/2025